NPI | 1336137330 |
---|---|
Former Name | PATRICK GARY O'DONNELL |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036-108929) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036108929) |
2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: IL 036-108929) | |
Enumeration Date | 2005-10-12 |
Last Update Date | 2014-01-03 |